Mathoulin-Pélissier S, Vicariot M, Courtois F, Waller C, Gross S, Verret C, Saves M, Eghbali H, Salmi L R
Centre national d'hémovigilance, Institut de santé publique d'épidémiologie et de développement, Bordeaux, France.
Transfus Clin Biol. 1998 Aug;5(4):266-74. doi: 10.1016/s1246-7820(98)80405-9.
The aim of this study was to assess the natural history of patients after transfusion and the acceptability of a standardized biological follow-up. In 1995, during 1 month, in 13 French hospitals, a follow-up at 3 and 6 months after blood transfusion was proposed to all blood recipients who had not received any blood transfusion within the past 6 months (eligible patients): screening for red cell antibodies, alanine aminotransferase (ALT) activity and specific viral markers of hepatitis B (hepatitis B surface antigen and antibody to hepatitis virus core antigen), of hepatitis C (antibodies) and of Human Immunodeficiency Virus (antibodies). At the beginning of the study, 296 patients were followed for 6 months. A complete follow-up was available at 3 months for 183 patients (62%), at 6 months for 168 (57%) and after 6 months, 198 patients (67%) have been once followed. Of eligible patients, 76% were alive at six months. After transfusion, the incidence of red cell alloantibodies and elevated ALT concentration were respectively 4% and 17%. At 6 months, one patient had Hepatitis B surface antigen; the responsibility of blood transfusion was excluded. Within the first 24 hours, 68 patients (23%) required another blood transfusion and 42% of units were transfused to patients with malignant disease. Our study quantifies in real conditions the difficulty of a biological follow-up in a transfused population, mostly composed of patients that could not be followed in the hospital where they were transfused.
本研究的目的是评估输血后患者的自然病程以及标准化生物学随访的可接受性。1995年，在1个月内，在法国的13家医院，对所有在过去6个月内未接受过任何输血的输血受者（符合条件的患者）进行输血后3个月和6个月的随访：筛查红细胞抗体、丙氨酸转氨酶（ALT）活性以及乙型肝炎（乙肝表面抗原和乙肝核心抗体）、丙型肝炎（抗体）和人类免疫缺陷病毒（抗体）的特异性病毒标志物。研究开始时，296名患者接受了6个月的随访。183名患者（62%）在3个月时有完整的随访数据，168名患者（57%）在6个月时有完整的随访数据，6个月后，198名患者（67%）曾接受过一次随访。符合条件的患者中，76%在6个月时存活。输血后，红细胞同种抗体的发生率和ALT浓度升高分别为4%和17%。6个月时，1例患者乙肝表面抗原呈阳性；输血的责任被排除。在最初的24小时内，68名患者（23%）需要再次输血，42%的单位血液输给了恶性疾病患者。我们的研究在实际情况下量化了输血人群中生物学随访的难度，该人群主要由在输血医院无法进行随访的患者组成。
